Diagnosis and management of cellulitis

@article{Phoenix2012DiagnosisAM,
  title={Diagnosis and management of cellulitis},
  author={Gokulan Phoenix and Saroj Kumar Das and Meera Joshi},
  journal={BMJ : British Medical Journal},
  year={2012},
  volume={345}
}
#### Summary points Cellulitis is an acute, spreading, pyogenic inflammation of the lower dermis and associated subcutaneous tissue. [] Key Method#### Sources and selection criteria We searched PubMed and the Cochrane library for recent and clinically relevant cohort studies and randomised controlled trials on cellulitis, using the search terms “cellulitis”, “erysipelas”, “diagnosis”, “investigation”, “recurrence”, “complications” and “management”.
Diagnosis and management of cellulitis and erysipelas.
TLDR
Large-scale controlled trial evidence for specific antimicrobial choices in the treatment of cellulitis and erysipelas is lacking, with national and local guidelines being based on a combination of best evidence, local epidemiology data and expert opinion.
Cellulitis: A Review.
TLDR
Treating predisposing factors can minimize risk of recurrence of cellulitis, and treatment of uncomplicated cellulitis should be directed against Streptococcus and methicillin-sensitive S. aureus.
A Retrospective Study: Erysipelas and Cellulitis Patients’ Profile
TLDR
The correct management could increase the recovery rate, prevent complication and recurrency of erysipelas and cellulitis, and determine a general overview as well as predictive factors of the severity of this acute infectious disease.
The Profile of Erysipelas and Cellulitis Patients
TLDR
The management of patients with erysipelas and cellulitis had been appropriate based on the diagnosis and treatment guidelines.
Diagnosis and treatment of the invasive extension of bacteria (cellulitis) from chronic wounds utilising point‐of‐care fluorescence imaging
TLDR
The utility of point‐of‐care fluorescence imaging for efficient detection and proactive, targeted management of wound‐related cellulitis is demonstrated.
Risk factors and complications of lower limb cellulitis in Africa: a systematic review
TLDR
The identification and improved management of the risk factors and factors associated with complications of lower limb cellulitis and its complications could go a long way in decreasing the morbidity and health costs incurred by lower limbs cellulitis in Africa.
Reducing Unnecessary Testing in Uncomplicated Skin and Soft Tissue Infections: A Quality Improvement Approach.
TLDR
A interdisciplinary team led a quality improvement project reducing unnecessary laboratory testing in patients with an uSSTI without patient harm, achieving their aim.
Evaluation of Antibiotic Treatment on the Duration of Hospitalization of Patients with Erysipelas and Bacterial Cellulitis
TLDR
It is suggested that this combination therapy with amoxicillin + clavulanic acid should be considered as a first-line treatment for patients hospitalized due to erysipelas or bacterial cellulitis, if other factors did not preclude the use of this therapy.
Evaluation and Management of Cellulitis and its Local Complications in Diabetic Lower Limb using the New Amit Jain’s Staging System for Cellulitis – A Retrospective study -
TLDR
This is the first study on cellulitis in diabetic lower limb through the new Amit Jain’s staging system from Indian subcontinent, and it is shown that stage 2 is the commonest presentation to a hospital.
Retrospective Evaluation of Risk Factors and Response in Treatment among Hospitalized Patients with Lower-Extremity Cellulitis
TLDR
Tinea pedis and chronic lymphedema were main risk factors for multiple attacks in patients with lowerextremity cellulitis and parenteral antibiotic treatment mostly used as the single drug regimen with ampicillinsulbactam was highly effective.
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References

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TLDR
It is the recommendation of this committee that patients with soft-tissue infection be distinguished by signs and symptoms of systemic toxicity (e.g., fever or hypothermia, tachycardia [heart rate,] and so on).
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TLDR
SSTI in hospital is associated with significant mortality, and choice of empirical therapy is not evidence based, with significant under-treatment of severely ill patients.
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TLDR
The capability of this VCDDSS to assist primary care physicians with generating a more accurate differential diagnosis (DDx) when confronted with patients presenting with possible skin infections is demonstrated.
The effect of soft-tissue ultrasound on the management of cellulitis in the emergency department.
TLDR
Soft-tissue US changes physician management in approximately half of patients in the ED with clinical cellulitis, which may guide management of cellulitis by detection of occult abscess, prevention of invasive procedures, and guidance for further imaging or consultation.
Staphylococcus aureus is the most common identified cause of cellulitis: a systematic review
TLDR
The most common aetiology of cellulitis with intact skin, when it can be determined, is S. aureus, outnumbering group A streptococcus by a ratio of nearly 2:1.
Cost-effectiveness of blood cultures for adult patients with cellulitis.
TLDR
The yield of blood cultures is very low, has a marginal impact on clinical management, and does not appear to be cost-effective for most patients with cellulitis.
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TLDR
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TLDR
This first case-control study highlights the major role of local risk factors (mainly lymphoedema and site of entry) in erysipelas of the leg and concludes that detecting and treating toe-web intertrigo should be evaluated in the secondary prevention of erYSipelasof the leg.
Lymphoedema and cellulitis: chicken or egg?
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TLDR
It is possible that patients who present with cellulitis may have a previously undiagnosed primary lymphatic abnormality which predisposes them to developing cellulitis but which may not present as overt lymphoedema until further lymphatic damage occurs as a result of the infection.
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TLDR
A case of primary cutaneous nocardiosis presenting as a mycetoma on the back is described, caused by Nocardia brasiliensis, and the help of a microbiologist allowed us to isolate the causative organism.
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